HomeMy WebLinkAboutBUILDING PERMIT APPPLICATIONALL APPLICABLE
(INFO
(yMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a� —� b -1 X Permit Number. ��a D1�G 5�
RECEIVED
Building Permit Application DEC 1820IB
Planning and Development Services Permitting De
Building and, Code Regulation Division St. Lucie Countyant
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION: NIVEQ
Arlrlrocv 702 BRACK ROAD, FORT PIERCE St. l Lzr
Legal Description: HUNT'S S/D BILK A LOTS 16 AND 17
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front
3403-701-0016-000-3
WILKENSON/REROOF
Back: Right Side: Left Side:
OF WORK:,
Lot No.
Block No.
TEAR OFF SHINGLE, RE -NAIL DECK. INSTALL NEW JA TAYLOR ROOFING 5V CRIMP METAL
PANEL ROOF SYSTEM OVER OWENS CORNING SELF -ADHERED UNDERLAYMENT.
CONSTRUCTION: INFORMATION: `
HUUILIUIIdI WUIR LU UC erlurrneu
OHVAC Gas Tank
unuer rnis
permn—cnecK au
Gas Piping
apply:
Shutters
❑
_
_
Windows/Doors
Electric
OPlumbing
Sprinklers Generator
Roof 2/12 Roof pitch
Total Sq. Ft of Construction: 3,200
S . Ft. of First Floor: 2,700
Cost of Construction:
$ 14,220
Utilities:liSewer
Oseptic
Building Height: 1 STORY
OWNER/LESSEE:" _ ,°
CONTRACT:OR :;, :.
Name BRADLEY& JANIE WILKENSON
Name: KYLE WHITE
Address: 702 BRACK RD
Company: J.A. TAYLOR ROOFING INC
City: FORT PIERCE State: FL
Zip Cade: 34982 Fax:
Phone No. 561-371-7967
Address: 302 MELTON DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8397
Phone No. 772-466-4040
E-Mail: BBJEM5@AOL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: NADINE@JATAYLORROOFING.COM
State or County License: CCC1325895
u varue or construction is �zbuu or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ of Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ t Applicable
Name:
BONDING COMPANY: _(,,,N6t Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your prope . A Notice of Commencement must be recorded and posted op4he jobsite
before the first inspectio yo 'ntend to obtain financing, consult with lender o a y before
commencin work cordi our Notice of Commencement.
Signat re of Owner/ Lessee/Contractor as Agent for Owner
Signature of ontractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledge efore me
this 74TH day of DECEMBER .26 by
this 14TH day of CECEMBER , 2t7 by
KYLEwHITE \1\1111111111111//
KYLE WHITE
Name of person making statement,.\.\\ 0\\......... ��i
Name of person making statement
Personally Known xx OR Produced 11 n� �N" P
.Personally Known xx OR Produced Identification
Type of Identificationyam.pe
of Identification
Pr duced
produced
RFF 936050
10
o .,(+� Son N.,es •�O2
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ter F!-ti
(Signat of Notary Public- State of19wi f 5V 0 N
(Signature of Notary Public- State of Florida Ic ST `1 �\\\\�
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Commission No. rFaasoso (Seal)
Commission No. rEeasoso zt.(Se'�SFj936050
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
LIM
Rev.8/2/17